Affiliation:
1. York Health Economics Consortium, University of York, York, U.K.
2. Global Health Outcomes, Eli Lilly and Company, Indianapolis, Indiana
Abstract
OBJECTIVE—Peripheral neuropathy is common among people with diabetes and can result in foot ulceration and amputation. The aim of this study was to quantify the annual medical costs of peripheral neuropathy and its complications among people with type 1 and type 2 diabetes in the U.S.
RESEARCH DESIGN AND METHODS—A cost-of-illness model was used to estimate the numbers of diabetic individuals in the U.S. who have diabetic peripheral neuropathy (DPN) and/or neuropathic foot ulcers (both those with no deep infection and those accompanied by cellulitis or osteomyelitis) at a given point in time, and/or a toe, foot, or leg amputation during a year. Prevalence and incidence rates were estimated from published studies and applied to the general U.S. population. All costs were estimated in 2001 U.S. dollars. In a sensitivity analysis, we varied the rates of complications to assess the robustness of the cost estimates.
RESULTS—The annual costs of DPN and its complications in the U.S. were $0.8 billion (type 1 diabetes), $10.1 billion (type 2 diabetes), and $10.9 billion (total). After allowing for uncertainty in the point estimates of complication rates, the range of costs were between $0.3 and $1.0 billion (type 1 diabetes), $4.3b and $12.7 billion (type 2 diabetes), and $4.6 and $13.7 billion (type 1 and type 2 diabetes).
CONCLUSIONS—The total annual cost of DPN and its complications in the U.S. was estimated to be between $4.6 and $13.7 billion. Up to 27% of the direct medical cost of diabetes may be attributed to DPN.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference20 articles.
1. Nicolucci A, Carinci F, Cavaliere D, Scorpiglione N, Belfiglio M, Labbrozzi D, Mari E, Benedetti MM, Tognoni G, Liberati A: A meta-analysis of trials on aldose reductase inhibitors in diabetic peripheral neuropathy. Diabet Med 13:1017–1026, 1996
2. Boulton AJM: The diabetic foot: a global view. Diabete Metab Res Rev 16:S2–S5, 2000
3. Gonzalez ER, Oley MA: The management of lower-extremity diabetic ulcers. Managed Care Interface 13:80–87, 2000
4. Reiber GE, Vileikyte L, Boyko EJ, Del Aguila M, Smith DG, Lavery LA, Boulton AJ: Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care 22:157–162, 1999
5. Mancini L, Ruotolo V: The diabetic foot: epidemiology. Rays 22:511–523, 1997
Cited by
530 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献